CMUNeXt: An Efficient Medical Image Segmentation Network based on Large Kernel and Skip Fusion

The U-shaped architecture has emerged as a crucial paradigm in the design of medical image segmentation networks. However, due to the inherent local limitations of convolution, a fully convolutional segmentation network with U-shaped architecture struggles to effectively extract global context information, which is vital for the precise localization of lesions. While hybrid architectures combining CNNs and Transformers can address these issues, their application in real medical scenarios is limited due to the computational resource constraints imposed by the environment and edge devices. In addition, the convolutional inductive bias in lightweight networks adeptly fits the scarce medical data, which is lacking in the Transformer based network. In order to extract global context information while taking advantage of the inductive bias, we propose CMUNeXt, an efficient fully convolutional lightweight medical image segmentation network, which enables fast and accurate auxiliary diagnosis in real scene scenarios. CMUNeXt leverages large kernel and inverted bottleneck design to thoroughly mix distant spatial and location information, efficiently extracting global context information. We also introduce the Skip-Fusion block, designed to enable smooth skip-connections and ensure ample feature fusion. Experimental results on multiple medical image datasets demonstrate that CMUNeXt outperforms existing heavyweight and lightweight medical image segmentation networks in terms of segmentation performance, while offering a faster inference speed, lighter weights, and a reduced computational cost. The code is available at https://github.com/FengheTan9/CMUNeXt.

WeakPolyp: You Only Look Bounding Box for Polyp Segmentation

Limited by expensive pixel-level labels, polyp segmentation models are plagued by data shortage and suffer from impaired generalization. In contrast, polyp bounding box annotations are much cheaper and more accessible. Thus, to reduce labeling cost, we propose to learn a weakly supervised polyp segmentation model (i.e., WeakPolyp) completely based on bounding box annotations. However, coarse bounding boxes contain too much noise. To avoid interference, we introduce the mask-to-box (M2B) transformation. By supervising the outer box mask of the prediction instead of the prediction itself, M2B greatly mitigates the mismatch between the coarse label and the precise prediction. But, M2B only provides sparse supervision, leading to non-unique predictions. Therefore, we further propose a scale consistency (SC) loss for dense supervision. By explicitly aligning predictions across the same image at different scales, the SC loss largely reduces the variation of predictions. Note that our WeakPolyp is a plug-and-play model, which can be easily ported to other appealing backbones. Besides, the proposed modules are only used during training, bringing no computation cost to inference. Extensive experiments demonstrate the effectiveness of our proposed WeakPolyp, which surprisingly achieves a comparable performance with a fully supervised model, requiring no mask annotations at all.

Unsupervised Polychromatic Neural Representation for CT Metal Artifact Reduction

Emerging neural reconstruction techniques based on tomography (e.g., NeRF, NeAT, and NeRP) have started showing unique capabilities in medical imaging. In this work, we present a novel Polychromatic neural representation (Polyner) to tackle the challenging problem of CT imaging when metallic implants exist within the human body. The artifacts arise from the drastic variation of metal's attenuation coefficients at various energy levels of the X-ray spectrum, leading to a nonlinear metal effect in CT measurements. Reconstructing CT images from metal-affected measurements hence poses a complicated nonlinear inverse problem where empirical models adopted in previous metal artifact reduction (MAR) approaches lead to signal loss and strongly aliased reconstructions. Polyner instead models the MAR problem from a nonlinear inverse problem perspective. Specifically, we first derive a polychromatic forward model to accurately simulate the nonlinear CT acquisition process. Then, we incorporate our forward model into the implicit neural representation to accomplish reconstruction. Lastly, we adopt a regularizer to preserve the physical properties of the CT images across different energy levels while effectively constraining the solution space. Our Polyner is an unsupervised method and does not require any external training data. Experimenting with multiple datasets shows that our Polyner achieves comparable or better performance than supervised methods on in-domain datasets while demonstrating significant performance improvements on out-of-domain datasets. To the best of our knowledge, our Polyner is the first unsupervised MAR method that outperforms its supervised counterparts.

Unsupervised augmentation optimization for few-shot medical image segmentation

The augmentation parameters matter to few-shot semantic segmentation since they directly affect the training outcome by feeding the networks with varying perturbated samples. However, searching optimal augmentation parameters for few-shot segmentation models without annotations is a challenge that current methods fail to address. In this paper, we first propose a framework to determine the ``optimal'' parameters without human annotations by solving a distribution-matching problem between the intra-instance and intra-class similarity distribution, with the intra-instance similarity describing the similarity between the original sample of a particular anatomy and its augmented ones and the intra-class similarity representing the similarity between the selected sample and the others in the same class. Extensive experiments demonstrate the superiority of our optimized augmentation in boosting few-shot segmentation models. We greatly improve the top competing method by 1.27\% and 1.11\% on Abd-MRI and Abd-CT datasets, respectively, and even achieve a significant improvement for SSL-ALP on the left kidney by 3.39\% on the Abd-CT dataset.

Meta-hallucinator: Towards Few-Shot Cross-Modality Cardiac Image Segmentation

Domain shift and label scarcity heavily limit deep learning applications to various medical image analysis tasks. Unsupervised domain adaptation (UDA) techniques have recently achieved promising cross-modality medical image segmentation by transferring knowledge from a label-rich source domain to an unlabeled target domain. However, it is also difficult to collect annotations from the source domain in many clinical applications, rendering most prior works suboptimal with the label-scarce source domain, particularly for few-shot scenarios, where only a few source labels are accessible. To achieve efficient few-shot cross-modality segmentation, we propose a novel transformation-consistent meta-hallucination framework, meta-hallucinator, with the goal of learning to diversify data distributions and generate useful examples for enhancing cross-modality performance. In our framework, hallucination and segmentation models are jointly trained with the gradient-based meta-learning strategy to synthesize examples that lead to good segmentation performance on the target domain. To further facilitate data hallucination and cross-domain knowledge transfer, we develop a self-ensembling model with a hallucination-consistent property. Our meta-hallucinator can seamlessly collaborate with the meta-segmenter for learning to hallucinate with mutual benefits from a combined view of meta-learning and self-ensembling learning. Extensive studies on MM-WHS 2017 dataset for cross-modality cardiac segmentation demonstrate that our method performs favorably against various approaches by a lot in the few-shot UDA scenario.

PELE scores: Pelvic X-ray Landmark Detection by Pelvis Extraction and Enhancement

The pelvis, the lower part of the trunk, supports and balances the trunk. Landmark detection from a pelvic X-ray (PXR) facilitates downstream analysis and computer-assisted diagnosis and treatment of pelvic diseases. Although PXRs have the advantages of low radiation and reduced cost compared to computed tomography (CT) images, their 2D pelvis-tissue superposition of 3D structures confuses clinical decision-making. In this paper, we propose a PELvis Extraction (PELE) module that utilizes 3D prior anatomical knowledge in CT to guide and well isolate the pelvis from PXRs, thereby eliminating the influence of soft tissue. We conduct an extensive evaluation based on two public datasets and one private dataset, totaling 850 PXRs. The experimental results show that the proposed PELE module significantly improves the accuracy of PXRs landmark detection and achieves state-of-the-art performances in several benchmark metrics, thus better serving downstream tasks.

Unified Multi-Modal Image Synthesis for Missing Modality Imputation

Multi-modal medical images provide complementary soft-tissue characteristics that aid in the screening and diagnosis of diseases. However, limited scanning time, image corruption and various imaging protocols often result in incomplete multi-modal images, thus limiting the usage of multi-modal data for clinical purposes. To address this issue, in this paper, we propose a novel unified multi-modal image synthesis method for missing modality imputation. Our method overall takes a generative adversarial architecture, which aims to synthesize missing modalities from any combination of available ones with a single model. To this end, we specifically design a Commonality- and Discrepancy-Sensitive Encoder for the generator to exploit both modality-invariant and specific information contained in input modalities. The incorporation of both types of information facilitates the generation of images with consistent anatomy and realistic details of the desired distribution. Besides, we propose a Dynamic Feature Unification Module to integrate information from a varying number of available modalities, which enables the network to be robust to random missing modalities. The module performs both hard integration and soft integration, ensuring the effectiveness of feature combination while avoiding information loss. Verified on two public multi-modal magnetic resonance datasets, the proposed method is effective in handling various synthesis tasks and shows superior performance compared to previous methods.

FedFTN: Personalized Federated Learning with Deep Feature Transformation Network for Multi-institutional Low-count PET Denoising

Low-count PET is an efficient way to reduce radiation exposure and acquisition time, but the reconstructed images often suffer from low signal-to-noise ratio (SNR), thus affecting diagnosis and other downstream tasks. Recent advances in deep learning have shown great potential in improving low-count PET image quality, but acquiring a large, centralized, and diverse dataset from multiple institutions for training a robust model is difficult due to privacy and security concerns of patient data. Moreover, low-count PET data at different institutions may have different data distribution, thus requiring personalized models. While previous federated learning (FL) algorithms enable multi-institution collaborative training without the need of aggregating local data, addressing the large domain shift in the application of multi-institutional low-count PET denoising remains a challenge and is still highly under-explored. In this work, we propose FedFTN, a personalized federated learning strategy that addresses these challenges. FedFTN uses a local deep feature transformation network (FTN) to modulate the feature outputs of a globally shared denoising network, enabling personalized low-count PET denoising for each institution. During the federated learning process, only the denoising network's weights are communicated and aggregated, while the FTN remains at the local institutions for feature transformation. We evaluated our method using a large-scale dataset of multi-institutional low-count PET imaging data from three medical centers located across three continents, and showed that FedFTN provides high-quality low-count PET images, outperforming previous baseline FL reconstruction methods across all low-count levels at all three institutions.

DiffULD: Diffusive Universal Lesion Detection

Universal Lesion Detection (ULD) in computed tomography (CT) plays an essential role in computer-aided diagnosis. Promising ULD results have been reported by anchor-based detection designs, but they have inherent drawbacks due to the use of anchors: i) Insufficient training targets and ii) Difficulties in anchor design. Diffusion probability models (DPM) have demonstrated outstanding capabilities in many vision tasks. Many DPM-based approaches achieve great success in natural image object detection without using anchors. But they are still ineffective for ULD due to the insufficient training targets. In this paper, we propose a novel ULD method, DiffULD, which utilizes DPM for lesion detection. To tackle the negative effect triggered by insufficient targets, we introduce a novel center-aligned bounding box padding strategy that provides additional high-quality training targets yet avoids significant performance deterioration. DiffULD is inherently advanced in locating lesions with diverse sizes and shapes since it can predict with arbitrary boxes. Experiments on the benchmark dataset DeepLesion show the superiority of DiffULD when compared to state-of-the-art ULD approaches.